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Question 1
Correct
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Choose the most correct answer, what reduces affinity for oxygen in haemoglobin?
Your Answer: All the options are true
Explanation:The strength with which oxygen binds to haemoglobin is affected by several factors. These factors shift or reshape the oxyhaemoglobin dissociation curve. A rightward shift indicates that the haemoglobin under study has a decreased affinity for oxygen. The causes of shift to right can be remembered using the mnemonic, CADET, face Right! for CO2 and CO, Acid (H+), 2,3-DPG, Exercise and Temperature.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 2
Correct
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5-methyltetrahydrofolate (Methyl THF) is converted to THF with the help of which of the following?
Your Answer: B 12
Explanation:MTR, also known as methionine synthase, is a methyltransferase enzyme, which uses the Vitamin B12 to transfer a methyl group from 5-methyltetrahydrofolate to homocysteine, thereby generating tetrahydrofolate (THF) and methionine. This functionality is lost in vitamin B12 deficiency, resulting in an increased homocysteine level and the trapping of folate as 5-methyl-tetrahydrofolate, from which THF (the active form of folate) cannot be recovered. THF plays an important role in DNA synthesis so reduced availability of THF results in ineffective production of cells with rapid turnover, in particular red blood cells, and also intestinal wall cells which are responsible for absorption.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 3
Incorrect
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The process in which tissue thromboplastin activates factor VII is best known as:
Your Answer: The intrinsic pathway
Correct Answer: The extrinsic pathway
Explanation:In the tissue factor pathway (extrinsic), following damage to the blood vessel, FVII leaves the circulation and comes into contact with tissue factor (TF) expressed on tissue-factor-bearing cells (stromal fibroblasts and leukocytes), forming an activated complex (TF-FVIIa).
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This question is part of the following fields:
- Haematology
- Medicine
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Question 4
Correct
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Iron absorption occurs primarily in which part of the GIT?
Your Answer: Duodenum
Explanation:Like most mineral nutrients, the majority of the iron absorbed from digested food or supplements is absorbed in the duodenum by enterocytes of the duodenal lining.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 5
Correct
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Question 6
Correct
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90% of erythropoietin necessary for haemopoesis is produced by the kidneys, the remainder is formed in the?
Your Answer: Liver
Explanation:Erythropoietin is produced by interstitial fibroblasts in the kidney in close association with peritubular capillary and proximal convoluted tubule. It is also produced in perisinusoidal cells in the liver. While liver production predominates in the fetal and perinatal period, renal production is predominant during adulthood.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 7
Correct
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The extrinsic coagulation pathway is initiated by activation of which clotting factor?
Your Answer: Factor VII
Explanation:The tissue factor pathway (extrinsic) begins following damage to the blood vessel. FVII leaves the circulation and comes into contact with tissue factor (TF) expressed on tissue-factor-bearing cells (stromal fibroblasts and leukocytes), forming an activated complex (TF-FVIIa).
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This question is part of the following fields:
- Haematology
- Medicine
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Question 8
Correct
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In the clotting mechanism, activation of factor IX can occur through the direct actions of:
Your Answer: Factor VIIa & XIa
Explanation:Factor IX is processed to remove the signal peptide, glycosylated and then cleaved by factor XIa (of the contact pathway) or factor VIIa (of the tissue factor pathway). When activated into factor IXa, in the presence of Ca2+, membrane phospholipids, and a Factor VIII cofactor, it hydrolyses one arginine-isoleucine bond in factor X to form factor Xa. Factor IX is inhibited by antithrombin.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 9
Correct
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Regarding Iron stores, which of the following contains the highest proportion of total body iron?
Your Answer: Haemoglobin
Explanation:Most well-nourished people in industrialized countries have 4 to 5 grams of iron in their bodies. Of this, about 2.5 g is contained in the haemoglobin needed to carry oxygen through the blood, and most of the rest (approximately 2 grams in adult men, and somewhat less in women of childbearing age) is contained in ferritin complexes that are present in all cells, but most common in bone marrow, liver, and spleen.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 10
Incorrect
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The following occurs as a result of 2,3 Bisphosphoglycerate binding to deoxyhaemoglobin
Your Answer: An increase in deoxyhaemoglobin's affinity for oxygen
Correct Answer: A reduction in deoxyhaemoglobin's affinity for oxygen
Explanation:2,3-BPG acts as a heteroallosteric effector of haemoglobin, lowering haemoglobin’s affinity for oxygen by binding preferentially to deoxyhaemoglobin. An increased concentration of BPG in red blood cells favours formation of the T, low-affinity state of haemoglobin and so the oxygen-binding curve will shift to the right.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 11
Correct
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The structure of haemoglobin A in adults includes
Your Answer: Haem, globin polypeptide chains α and β
Explanation:Haemoglobin A (HbA), also known as adult haemoglobin or α2β2, is the most common human haemoglobin tetramer, comprising over 97% of the total red blood cell haemoglobin. It consists of two alpha chains and two beta chains.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 12
Incorrect
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Bone marrow barrier is important to:
Your Answer: All of the above
Correct Answer: Allow mature red blood cells to pass into circulation
Explanation:The blood vessels of the bone marrow constitute a barrier, inhibiting immature blood cells from leaving the marrow. Only mature blood cells contain the membrane proteins, such as aquaporin and glycophorin, that are required to attach to and pass the blood vessel endothelium.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 13
Correct
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Which of the following cells will degranulate and release histamine when binding to IgE?
Your Answer: Basophils
Explanation:Basophils have protein receptors on their cell surface that bind IgE, an immunoglobulin involved in microparasite defence and allergy. When activated, basophils degranulate to release histamine, proteoglycans (e.g. heparin and chondroitin), and proteolytic enzymes (e.g. elastase and lysophospholipase).
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This question is part of the following fields:
- Haematology
- Medicine
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Question 14
Incorrect
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Which of the following conditions is associated with eosinophilia?
Your Answer: Long-term corticosteroid use
Correct Answer: Ascaris
Explanation:Eosinophilia can be idiopathic (primary) or, more commonly, secondary to another disease. In the Western World, allergic or atopic diseases are the most common causes, especially those of the respiratory or integumentary systems. In the developing world, parasites are the most common cause e.g. Ascaris
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This question is part of the following fields:
- Haematology
- Medicine
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Question 15
Incorrect
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Stem cell characteristics include the following except
Your Answer: Plasticity
Correct Answer: Differentiation and proliferation into progenitor cells committed to multiple cell lines
Explanation:The classical definition of a stem cell requires that it possess two properties:Self-renewal: the ability to go through numerous cycles of cell division while maintaining the undifferentiated state.Potency: the capacity to differentiate into specialized cell types. In the strictest sense, this requires stem cells to be either totipotent or pluripotent to be able to give rise to any mature cell type
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This question is part of the following fields:
- Haematology
- Medicine
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Question 16
Correct
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Where is Vitamin B 12 absorbed?
Your Answer: Terminal ileum
Explanation:Protein-bound vitamin B12 must be released from the proteins by the action of digestive proteases in both the stomach and small intestine. Gastric acid releases the vitamin from food particles; therefore antacid and acid-blocking medications (especially proton-pump inhibitors) may inhibit absorption of B12. B12 must be attached to Intrinsic Factor (IF) for it to be efficiently absorbed, as receptors on the enterocytes in the terminal ileum of the small bowel only recognize the B12-IF complex; in addition, intrinsic factor protects the vitamin from catabolism by intestinal bacteria.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 17
Correct
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Which of these vitamins is not found in plants?
Your Answer: Vitamin B12
Explanation:No fungi, plants, nor animals (including humans) are capable of producing vitamin B12. Only bacteria and archaea have the enzymes needed for its synthesis. Proved food sources of B12 are animal products (meat, fish, dairy products).
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This question is part of the following fields:
- Haematology
- Medicine
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Question 18
Incorrect
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The following play a role in regulation of intestinal iron absorption except:
Your Answer: Hereditary hemochromatosis gene
Correct Answer: Urinary iron excretion rate
Explanation:The human body’s rate of iron absorption appears to respond to a variety of interdependent factors, including total iron stores, dietary intake, the extent to which the bone marrow is producing new red blood cells, the concentration of haemoglobin in the blood, and the oxygen content of the blood. Classic examples of genetic iron overload includes hereditary hemochromatosis (HH) and the more severe disease juvenile hemochromatosis (JH).
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This question is part of the following fields:
- Haematology
- Medicine
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Question 19
Incorrect
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In adults, the major site of haematopoiesis is?
Your Answer: The proximal ends of long bones
Correct Answer: The axial skeleton
Explanation:Bone marrow is the flexible tissue in the interior of bones. In humans, red blood cells are produced by cores of bone marrow in the heads of long bones.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 20
Incorrect
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Question 21
Incorrect
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Question 22
Correct
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Lymphoid stem cells give rise to the following cells:
Your Answer: T cells, b cells and natural killer cells
Explanation:T Cells, B Cells and NK Cells (and all other Innate lymphoid cells) are unique to the lymphocyte family, but dendritic cells are not. Dendritic cells of identical appearance but different markers are spread throughout the body, and come from either lymphoid and myeloid lineages.
Myeloid stem cells lead to myeloblasts, which evolve into macrophages, monocytes, neutrophils, basophils, and eosinophils.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 23
Correct
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With regards to splenic micro-architecture which is not contained within the red pulp
Your Answer: Malpighian corpuscles
Explanation:Red pulp is responsible for mechanical filtration of red blood cells and is composed of sinusoids, which are filled with blood, splenic cords of reticular fibers and a marginal zone bordering on white pulp. White pulp provides an active immune response through humoral and cell-mediated pathways. Composed of nodules, called Malpighian corpuscles. These are composed of: lymphoid follicles, rich in B-lymphocytes and periarteriolar lymphoid sheaths (PALS), rich in T-lymphocytes.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 24
Incorrect
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Which of the following is true regarding platelets?
Your Answer: They are nucleated
Correct Answer: Normally have a half-life of about 8 days
Explanation:Platelets have no cell nucleus: they are fragments of cytoplasm that are derived from the megakaryocytes of the bone marrow, and then enter the circulation. They have a half life of 5-9 days.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 25
Correct
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One of the cells of the bone marrow that are responsible for forming the various forms of differentiated blood cells are called?
Your Answer: Hematopoietic stem cell
Explanation:Hematopoietic stem cells (HSCs) or hemocytoblasts are the stem cells that give rise to all the other blood cells through the process of haematopoiesis. They are derived from mesoderm and located in the red bone marrow, which is contained in the core of most bones.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 26
Incorrect
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Question 27
Incorrect
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Question 28
Correct
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Which enzyme deficiency causes Beriberi?
Your Answer: Thiamine
Explanation:Beriberi refers to a cluster of symptoms caused primarily by thiamine (vitamin B1) deficiency. Symptoms of beriberi include weight loss, emotional disturbances, impaired sensory perception, weakness and pain in the limbs, and periods of irregular heart rate.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 29
Correct
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Which of the following vitamin deficiencies is associated with xerophthalmia?
Your Answer: Vitamin A
Explanation:Xerophthalmia caused by a severe vitamin A deficiency is described by pathologic dryness of the conjunctiva and cornea. The conjunctiva becomes dry, thick and wrinkled. If untreated, it can lead to corneal ulceration and ultimately to blindness as a result of corneal damage.
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This question is part of the following fields:
- Haematology
- Medicine
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Question 30
Incorrect
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The intrinsic pathway of coagulation is activated by which of the following?
Your Answer: Activation of factor viii
Correct Answer: Collagen fibers underlying the endothelium
Explanation:The contact activation (intrinsic) pathway begins with formation of the primary complex on collagen by high-molecular-weight kininogen (HMWK), prekallikrein, and FXII (Hageman factor).
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This question is part of the following fields:
- Haematology
- Medicine
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